Time on the Farm Helps Psychiatric Patients

April 11, 2008-- Contact with farm animals may be therapeutic for patients with mental illness, much the way interaction with cats and dogs is, researchers found.
Working with cows, sheep, and other animals on small farms in Norway for 12 weeks modestly improved patients' sense of self-efficacy and coping ability, reported Bente Berget, of the Norwegian University of Life Sciences here, and colleagues online in Clinical Practice and Epidemiology in Mental Health.
Farm animals, plants, and gardens have been used as part of recreational and work-related interventions under the banner of "Green Care" for psychiatric patients, which has been gaining popularity in Europe as well as the United States, the researchers said.
These interventions were typically done at farms associated with hospitals or other healthcare institutions but now more commonly include community gardens, city farms, allotment gardens, and private farms, the researchers said.
Previous studies have shown that animal-assisted therapy involving cats and dogs can decreased stress and improve self-confidence, social competence, and quality of life.
To see if farm animals could provide the same benefits, the researchers randomized 90 adult psychiatric patients to a 12-week intervention with farm animals along with their normal medication or to standard treatment alone.
The participants were predominantly outpatients (84.5%). Their most common diagnoses were schizophrenia (37.7%), affective disorders (24.4%), and anxiety and stress-related disorders (11.1%).
The intervention involved 15 farmers who were mostly inexperienced in working with psychiatric patients. Ten of the farms had dairy cows, two had sheep, one had horses, and two had cattle for specialized meat production. All the farms also had small animals like rabbits, poultry, pigs, cats, or dogs.
One or two patients at a time visited the farms to work with the animals for three hours twice a week. The farmers were always close by to ensure that there were no risks from contact with the animals.
The researchers found no benefits during the relatively brief intervention for patients compared with controls. But "a rapid and great improvement" was unlikely, they said, because 72% of the patients had been under psychiatric care for more than three years.
However, six months later, patients in the farm intervention group were more likely to report that they were better able to respond to new or difficult situations than those in the control group.
Self-efficacy scores increased significantly by six months in the treatment group compared with preintervention scores (25.7 versus 23.1, P=0.05) and postintervention scores (25.7 versus 23.5, P=0.02). There was no improvement in the control group (25.4 versus 25.3 and 25.6).
Coping ability, measured using the Coping Strategies Scale of the Pressure Management Indicator, also improved at six months for those working with the farm animals compared with before the intervention (P=0.03), whereas no increases were seen in the control group.
None of the differences between or within groups overall were significant for quality of life, although controlled studies with pets had shown improvements in quality of life, the researchers noted.
Patients with affective disorders appeared to gain the most from contact with farm animals.
Their self-efficacy scores improved compared with the control group both during the intervention (P=0.03) and six months after (P=0.01). Their quality of life increased as well (P=0.01).
The delayed effects in the overall cohort may suggest that the intervention or the study was too short, the investigators said. It's also possible that the frequency of farm visits was too low for significant benefits to accrue, they said.
They noted that the study was limited by the moderate number of patients with each psychiatric condition and the lack of blinding to active treatment.
"Even if the results on self-efficacy and coping are rather moderate," Berget and colleagues concluded, "they are positive based on the limited sample size and the rather unspecific intervention."
The study was funded by a grant from the Research Council of Norway.
The researchers reported no conflicts of interest.
Additional source: Clinical Practice and Epidemiology in Mental HealthSource reference: Berget B, et al "Animal-assisted therapy with farm animals for persons with psychiatric disorders: effects on self-efficacy, coping ability and quality of life, a randomized controlled trial" Clin Pract Epidemol Ment Health 2008; 4: 9.